Numerical and analytical investigation of irrigant penetration into dentinal microtubules

Irrigation is one of the most important steps in root canal therapy. Sodium hypochlorite is inserted into the root canal to eliminate bacteria and dissolve necrotic tissue. Dentinal tubules are micrometer sized channels along the dentin thickness. An irrigant should have the ability to penetrate into these tubules to remove bacteria residing in them. The difference between the concentrations of the inserted irrigant and the dentinal tubule fluid is the main factor of penetration. This study attempts to model dentinal tubules with precise dimensions and to study the time dependent irrigant penetration into them by using Computational Fluid Dynamics (CFD). The effects of needle type and position in the dentinal tubule were also considered. The results showed that concentration distribution would be different when the tubule was modeled as a frustum compared to the cylindrical shape tubule. Dentinal tubule curvature, however, did not have a noticeable effect in irrigant penetration. It was also concluded that when the needle working length is 3 mm, concentration can be considered constant at the tubule's entrance for tubules located at more than 1 mm from the apex. Moreover, by irrigating the root canal with a side-vented needle instead of an open-ended one, the concentration would be less for the tubules located in the apex region. Analytical solutions for different cases were also obtained, and their predictions were found to be in good agreement with the numerical results. Therefore, the presented analytical solutions can be directly used to obtain irrigant concentration in tubules with no need for additional computer simulations.

[1]  R Garberoglio,et al.  Scanning electron microscopic investigation of human dentinal tubules. , 1976, Archives of oral biology.

[2]  Michel Versluis,et al.  Evaluation of irrigant flow in the root canal using different needle types by an unsteady computational fluid dynamics model. , 2010, Journal of endodontics.

[3]  E. Kastrinakis,et al.  Measurement of pressure and flow rates during irrigation of a root canal ex vivo with three endodontic needles. , 2007, International endodontic journal.

[4]  M. Versluis,et al.  Irrigant transport into dental microchannels , 2013 .

[5]  C. Coffey,et al.  Analysis of human dentinal fluid. , 1970, Oral surgery, oral medicine, and oral pathology.

[6]  Franklin R Tay,et al.  Effect of vapor lock on root canal debridement by using a side-vented needle for positive-pressure irrigant delivery. , 2010, Journal of endodontics.

[7]  John Crank,et al.  The Mathematics Of Diffusion , 1956 .

[8]  Ya Shen,et al.  Irrigation in endodontics. , 2010, Dental clinics of North America.

[9]  L W M van der Sluis,et al.  Irrigant flow in the root canal: experimental validation of an unsteady Computational Fluid Dynamics model using high-speed imaging. , 2010, International endodontic journal.

[10]  I. Yimer,et al.  Estimation of the turbulent Schmidt number from experimental profiles of axial velocity and concentration for high-reynolds-number jet flows , 2002 .

[11]  I A Mjör,et al.  The density and branching of dentinal tubules in human teeth. , 1996, Archives of oral biology.

[12]  C Boutsioukis,et al.  Irrigant flow within a prepared root canal using various flow rates: a Computational Fluid Dynamics study. , 2009, International endodontic journal.

[13]  Yuan Gao,et al.  Development and validation of a three-dimensional computational fluid dynamics model of root canal irrigation. , 2009, Journal of endodontics.

[14]  Yuan Gao,et al.  Three-dimensional numeric simulation of root canal irrigant flow with different irrigation needles. , 2010, Journal of Endodontics.

[15]  Ove A Peters,et al.  Current challenges and concepts in the preparation of root canal systems: a review. , 2004, Journal of endodontics.

[16]  Di Zhang,et al.  Numerical investigation of root canal irrigation adopting innovative needles with dimple and protrusion. , 2013, Acta of bioengineering and biomechanics.

[17]  P. Wesselink,et al.  Reaction rate of NaOCl in contact with bovine dentine: effect of activation, exposure time, concentration and pH. , 2010, International endodontic journal.

[18]  Michel Versluis,et al.  The effect of needle-insertion depth on the irrigant flow in the root canal: evaluation using an unsteady computational fluid dynamics model. , 2010, Journal of endodontics.

[19]  Simon Zabler,et al.  3D variations in human crown dentin tubule orientation: a phase-contrast microtomography study. , 2010, Dental materials : official publication of the Academy of Dental Materials.

[20]  Stephen Cohen,et al.  Pathways of the Pulp , 1976 .

[21]  R. Love Invasion of dentinal tubules by root canal bacteria , 2004 .

[22]  P. Carrigan,et al.  A scanning electron microscopic evaluation of human dentinal tubules according to age and location. , 1984, Journal of endodontics.

[23]  D. Ørstavik,et al.  Inactivation of local root canal medicaments by dentine: an in vitro study. , 2000, International endodontic journal.

[24]  P. Wesselink,et al.  Factors promoting the tissue dissolving capability of sodium hypochlorite. , 1982, International endodontic journal.

[25]  Shahriar Shahriari,et al.  Comparison of removed dentin thickness with hand and rotary instruments , 2009, Iranian endodontic journal.